System and method for monitoring a fall state of a patient while minimizing false alarms

ABSTRACT

Various embodiments concern a system for monitoring a patient in a bed, the system comprising a camera, a user interface comprising a screen, and a computing system. The computing system can be configured to monitor, with the camera, for motion within each of a plurality of zones, the plurality of zones comprising a one or more inner zones extending adjacent along the bed, one or more outer zones extending adjacent along the one or more inner zones, and one or more end zones. Motion within the inner zones can trigger a fall alert while motion within the outer or end zones can suspend one or more functions to prevent the fall alert from being issued. The end zones can comprise a bottom zone and one or more top zones.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims priority to Provisional Application No.61/707,227, filed Sep. 28, 2012, which is herein incorporated byreference in its entirety.

FIELD OF INVENTION

The present disclosure relates generally to systems and methods forpatient monitoring by analyzing video frames to detect patient events.More particularly, the present disclosure relates to algorithms thatdetect activity indicative of a patient at risk of a fall whileminimizing false alarms.

BACKGROUND

Healthcare facilities rely on patient monitoring to supplementinterventions and reduce the instances of patient falls. Constanteyes-on monitoring of patients can be difficult for healthcareprofessionals to maintain. Video monitoring can be used to automatepatient monitoring and increase the ability of a healthcare professionalto effectively monitor a group of patients distributed between differentrooms. Various systems and methods for patient video monitoring havebeen disclosed, such as U.S. Patent Application No. 2009/0278934entitled System and Method for Predicting Patient Falls, U.S. PatentApplication No. 2010/0134609 entitled System and Method for DocumentingPatient Procedures; and U.S. Patent Application No. 2012/0026308entitled System and Method for Using a Video Monitoring System toPrevent and Manage Decubitus Ulcers in Patients, each of which isincorporated herein by reference in its entirety.

Various routines can be run to analyze the output of a camera andidentify events. An alert can be issued to summon a healthcareprofessional to intervene when events are detected. Such an automatedsystem may be susceptible to false alarms, which can burden a staff ofhealthcare professionals with unnecessary interventions. For example, afalse alarm can be triggered by patient activity that is not indeedindicative of an increased risk of a patient fall. A false alarm canalso be triggered by the activity of a visitor (e.g., healthcareprofessional, family of patient) around the patient. There exists a needfor systems and methods for accurately recognizing conditions in whichthe patient is at high risk of a fall while also minimizing falsealarms.

SUMMARY

Various embodiments of this disclosure concern a system for monitoring apatient in a bed. Such a system comprises a camera configured to outputa plurality of frames of the bed and a computing system. The computingsystem is configured to receive the plurality of frames from the cameraand output an image of a bed for display on a screen of a user interfacebased on at least one of the plurality of frames. A user can input anindication of at least one location associated with the bed with theuser interface and the computing system can be configured to receive theindication of the at least one location. The computing system is furtherconfigured to define a plurality of zones based on the indication of theat least one location. The plurality of zones can comprise a left innerzone that extends adjacently along a left side of the bed, a left outerzone that extends adjacently along a left side of the left inner zone, aright inner zone that extends adjacently along a right side of the bed,a right outer zone that extends adjacently along a right side of theright inner zone, and at least one end zone, each end zone extends alonga respective top or bottom side of the bed. The computing system isconfigured to monitor for motion within each of the plurality of zonesbased on at least some of the plurality of frames. The computing systemis configured to issue an alert with the user interface based on motionbeing detected in one or both of the left inner zone and the right innerzone. The computing system is further configured to initiate adeactivation timer if motion is detected in any of the at least one leftouter zone, the right outer zone, and the at least one end zone. Thedeactivation timer counts for a predetermined duration and one or morefunctions of the computing system are suspended for the duration of thecounting to prevent the issuing of the alert.

The at least one end zone can comprise a bottom zone that extendsadjacently along the bottom side of the bed and a top zone on the topside of the bed. In some cases, the at least one end zone can comprise apair of top zones, one of the top zones extending adjacent along both ofthe left outer zone and the left inner zone, and the other top zoneextending adjacent along both of the right outer zone and the rightinner zone.

Various embodiments of this disclosure concern a method for monitoring apatient in a bed. Such a method can comprise receiving a plurality offrames of a bed from a camera at a computing system and receiving anindication of at least one location associated with the bed at thecomputing system from a user interface. The method further includesdefining a plurality of zones based on the indication of the at leastone location, the plurality of zones defined at least in part by thecomputing system. The plurality of zones can comprise a left inner zonethat extends along a left side of the bed, a left outer zone thatextends along a left side of the left inner zone, a right inner zonethat extends along a right side of the bed, a right outer zone thatextends along a right side of the right inner zone, and at least one endzone, each end zone extending along a respective top or bottom side ofthe bed. The method further includes monitoring for motion within eachof the plurality of zones based on at least some of the plurality offrames, the monitoring performed by the computing system. The methodfurther includes issuing an alert based on motion being detected in oneor both of the left inner zone and the right inner zone, the alertissued at least in part by the computing system. The method alsoincludes initiating a deactivation timer of the computing system basedon motion being detected in any of the at least one left outer zone, theright outer zone, and the at least one end zone. The deactivation timercounts for a predetermined duration and one or more functions of thecomputing system are suspended for the duration of the counting toprevent the issuing of the alert.

While multiple embodiments are disclosed, still other embodiments of thepresent disclosure will become apparent to those skilled in the art fromthe following detailed description. Accordingly, the drawings anddetailed description are to be regarded as illustrative in nature andnot restrictive.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic illustration of a monitoring system.

FIG. 2 is a block diagram of components of a monitoring system.

FIG. 3 is a schematic diagram of a patient area.

FIG. 4 is a schematic diagram of the patient area of FIG. 3 showingdesignated lateral sides of the bed.

FIG. 5 is a schematic diagram of the patient area of FIG. 4 showingdesignated longitudinal ends of the bed.

FIG. 6 is a schematic diagram of the patient area of FIG. 5 showinginner zones.

FIG. 7 is a schematic diagram of the patient area of FIG. 7 showingouter zones and end zones.

FIG. 8 is a flowchart of a method for initializing a monitoring system.

FIG. 9 is a flow chart of a method for monitoring a patient whileminimizing false alarms.

While the subject matter of the present disclosure is amenable tovarious modifications and alternative forms, specific embodiments havebeen shown by way of example in the drawings. The intention, however, isnot to limit the invention to the particular embodiments shown anddescribed. On the contrary, the scope of the invention is intended tocover all modifications, equivalents, and alternatives as defined by theappended claims.

DETAILED DESCRIPTION

Various embodiments of the present disclosure concern video monitoringto detect patient events. Such events can concern situations in which apatient is at increased risk or otherwise is in need of intervention.Patient events can include a patient at risk of falling, a patientfalling, a patient outside of a designated area, and patient motion,among various other events.

FIG. 1 is a schematic diagram of a patient monitoring system 14. Thepatient monitoring system 14 can allow a healthcare professional tomonitor multiple patient areas from a monitoring station 15 via acomputing system 17. The monitoring station 15 can comprise a userinterface, which can include a screen and an input. The screen candisplay images of the patient areas, indications of one or more statesof the patients being monitored, patient data, and/or other information.In some embodiments, some or all of the components of the monitoringstation 15 are portable such that the monitoring station 15 can movewith the healthcare processional.

While four patient areas are shown in FIG. 1, any number of patientareas can be monitored at the monitoring station 15 via the computingsystem 17. The monitoring station 15 can be remote from the patientareas. For example, the monitoring station 15 can be on the same ordifferent floor as the patient areas, in the same or different buildingas the patient areas, or located in a geographically different locationas the patient areas. Furthermore, the patient areas can be remote fromeach other. The computing system 17 can be in one particular location orthe components of the computing system 17 can be distributed amongstmultiple locations. The computing system 17 can be at the monitoringstation 15 or can be remote from the monitoring station 15 and/or thepatient areas.

As shown in FIG. 1, a plurality of cameras 18-21 can be respectivelypositioned to view and generate frames of the plurality of patientareas. Information concerning the frames, such as analog or digitalencodings of the frames, can be transmitted from the plurality ofcameras 18-21 along data channels 16 to the computing system 17. In somecases, the computing system 17 is a single unit, such as a server or apersonal computer (e.g., a desktop computer or a laptop computer). Insome cases, the computing system 17 is distributed amongst severalunits, such as one or more personal computers, one or more servers,circuitry within one or more of the cameras 18-21, and/or othercomputing devices. In some cases, the computing system 17 is part of acloud computing network. The data channels 16 can be wired lines of anetwork (e.g., a local area network) and/or wireless channels (e.g.,Wi-Fi or cellular network).

Each of the plurality of cameras 18-21 can generate a chronologicalseries of frames (e.g., as images). The plurality of cameras 18-21 canbe analog or digital cameras. Each of the plurality of cameras 18-21 cancapture a sequence of frames at a predetermined frame rate, such as six,eight, sixteen, twenty-four, or some other number of frames per second.The resolution of digital cameras is usually defined by the number ofpixels both horizontally and vertically (such as 640×480) or as a totalnumber of pixels in the image (such as 1.4 mega pixels), while theresolution of analog video cameras is typically defined by the number oftelevision lines. Analog frames can be converted to digital frames byanalog-to-digital conversion circuitry (e.g., as part of the computingsystem 17 and/or the plurality of cameras 18-21). The plurality ofcameras 18-21 can have infrared illumination or night visioncapabilities for operating in low light conditions.

FIG. 2 shows a block diagram of circuitry of the monitoring system 14.It will be understood that the arrangement of circuitry represented inassociation with the camera 18 and the computing system 17 is an exampleand that various other configurations are possible. The camera 18 caninclude optics 30. Optics 30 can include a lens, a filter, and/or othercomponents for capturing and conditioning the light of the patient area.The camera 18 can further include a sensor 31 for converting light fromthe optics 30 into electronic signals. Different types of sensors 31 canbe used depending on whether the camera 18 is analog (e.g., generatinganalog video) or digital (e.g., generating discrete digital frames). Thesensor 31 can include a charge-coupled device (CCD) or a complementarymetal-oxide-semiconductor (CMOS), for example.

The camera 18 can further include a processor 32 and memory 33. Theprocessor 32 can perform various computing functions, such as thosedescribed herein or otherwise useful for operating the camera 18. Thememory 33 can be a non-transient computer readable storage medium (e.g.,random access memory or flash) for storing program instructions and/orframes. For example, the processor 32 can be configured to executeprogram instructions stored on the memory 33 for controlling the camera18 in converting light from the patient area into digital signals withthe sensor 31, storing the digital signals on the memory 33 as framedata, transferring the frame data to the computing system 17, and/orperforming any other function referenced herein. The processor 32 mayperform various signal conditioning and/or image processing on theframes. The processor 32 may include a dedicated video processor forimage processing. Although not illustrated, the camera 18 can furtherinclude a network interface controller and a power supply. The camera 18may include a user interface which can include user controls and/or anaudible alarm.

The computing system 17 can comprise a single housing or multiplehousings among which circuitry can be distributed. The computing system17 can include display circuitry 34 which can provide a graphics outputto a screen. Display circuitry 34 can include a graphics processor andgraphics memory which can support user interface functionality. Displaycircuitry 34 may be part of a separate display, such as a screen,handheld device, or remote terminal. Display circuitry 34 can facilitatethe display of frames taken by the camera 18 of the patient area on ascreen and/or patient status information. User input circuitry 35 cansupport user interface functionality and can include components foraccepting user commands such as a keyboard, mouse, trackball, touchpad,touch screen, joystick, slider bar, or any other control. User inputcircuitry 35 can facilitate the definition of boundaries and monitoringzones, as will be further described herein. The computing system 17 caninclude one or more user interfaces for issuing an alert, such as analert indicating a patient fall or a heightened patient fall state. Forexample, the user interface can include a screen which can display anotification indicating a patient fall or a heightened patient fallstate. The user interface can include a light that can indicate apatient fall or a heightened patient fall state. The user interface caninclude a speaker that can produce a sound indicating a patient fall ora heightened patient fall state. For example, the user interface mayplay a prerecorded message to indicate a patient fall or a heightenedpatient fall state. The user interface can include a vibration elementthat can noticeably vibrate to indicate a patient fall or a heightenedpatient fall state. The user interface can be distributed among multipledevices such that multiple users can carry different portable devices ofthe user interface (e.g., smart phones, tablet computers, pagers, etc.)which can be activated to indicate the alert.

The computing system 17 can include a processor 36 and memory 37. Thememory 37 can be one or more discrete non-transient computer readablestorage medium components (e.g., RAM, ROM, NVRAM, EEPROM, and/or FLASHmemory) for storing program instructions and/or data. The processor 36can be configured to execute program instructions stored on the memory37 to control in the computing system 17 in carrying out the functionsreferenced herein. The processor 36 can comprise multiple discreteprocessing components to carry out the functions described herein as theprocessor 36 is not limited to a single processing component. Thecomputing system 17 can include a network controller 38 for facilitatingcommunication with the cameras 18-21 and/or other remote components. Thecomputing system 17 can include a power supply 39 which can facilitate aconnection to an electrical outlet and/or the power supply 39 cancomprise a battery. Whether distributed or unified, the components ofthe computing system 17 can be electrically connected to coordinate andshare resources to carry out functions.

The computing system 17 and the camera 18 can be employed to monitor apatient area and issue an alert if indications that a patient is atincreased risk of fall are detected. Such monitoring can be performed byestablishing one or more monitoring's zones around a patient area (e.g.,a bed or other elevated patient support surface) to detect patientmovement or presence in an area that is indicative of a patient exitingthe bed, as further discussed herein.

FIG. 3 shows an illustration of a room that includes a bed 60. Theillustrated view shown in FIG. 3 can correspond to the view of thecamera 18 as positioned along a near wall (not illustrated) of the room.As shown, the bed 60 includes a longitudinal dimension 61 and a widthdimension 62. A user (e.g., a health care professional) can view animage similar to the illustration of FIG. 3 on a screen from a remotelocation. The user can input an indication of at least one locationassociated with a patient area using a user interface such as a touchscreen, keyboard, mouse or other input. In this case the patient areacorresponds to the main surface of the bed 60 (i.e. the surface on whichthe patient 63 lies) and the user input can designate various locationsassociated with the bed 60 on the screen via the user input. In somecases, a user can indicate one or more boundaries of the bed surface orother patient area associated with heightened fall risk. It will beappreciated that a patient is most likely to fall from the left side 64or the right side 65 of the bed 60 and is less likely to fall from thetop 66 or the bottom 67 of the bed 60. Accordingly, the left side 64 anda right side 65 of the bed 60 can be designated by the user formonitoring. FIG. 4 shows a left boundary designation 70 corresponding tothe left side 64 of the bed 60 and a right boundary designation 71corresponding to the right side 65 of the bed 60. Left and rightdirections will be described herein from the patient's 63 perspective,which is opposite to that of the user's perspective. The left and rightboundary designations 70, 71 can be input by a user viewing a displayedimage of the bed 60 on a screen. The left and right boundarydesignations 70, 71 can indicate the boundaries of a patient zone (e.g.,the supporting surface of the bed 60). In some cases, a top 66 of thebed 60 (corresponding to the head of the bed 60), and/or a bottom 67 ofthe bed 60 (corresponding to the foot of the bed 60) can additionally oralternatively be designated by a user. Some monitoring systems may beconfigured to assume that two generally parallel boundary designationsinput by a user represent left and right sides of the bed 60 spanning alongitudinal dimension 61 of the bed 60. Based on the left and rightboundary designations 70, 71, one or more additional boundaries and/or aplurality of monitoring zones can be automatically defined.

FIG. 5 illustrates the completion of a boundary defining a patient zoneby an algorithm. Specifically, the ends of the left and right boundarydesignations 70, 71 are connected by a top boundary designation 72 and abottom boundary designation 73. Further, a midline 75 can be definedbased on connecting the respective midpoints (or some other commonpoint) of the left and right boundary designations 70, 71. The algorithmcan automatically identify two substantially parallel designated lines(e.g., the left and right boundary designations 70, 71) and can connectthe ends of the two identified lines (e.g., to form the top boundarydesignation 72 and a bottom boundary designation 73) to define aconfined patient zone. As such, a user can designate one or morelocations of a patient area and a monitoring system can defineboundaries defining some or all sides of the patient zone. Themonitoring system can further define one or more monitoring zones withinand/or outside of the patient zone, as shown in FIG. 6.

FIG. 6 illustrates the boundaries of multiple monitoring zones. Themonitoring zones can be defined by an algorithm of a monitoring systembased on a user input, such as the left and right boundary designations70, 71. The monitoring zones can be defined to be along a single planein space, and in some embodiments the plane can be aligned with the mainpatient supporting surface of the bed 60 on which the patient lies. Themonitoring zones can include upper right inner zone 2, upper patientzone 3, upper left inner zone 4, lower right inner zone 7, lower patientzone 8, and lower left inner zone 9. The patient 63 can normally occupythe upper and lower patient zones 3, 8 while the presence of the patient63 in the inner zones 2, 4, 7, 9 can indicate a heightened fall risk forthe patient 63. Motion can be monitored with the inner zones 2, 4, 7, 9to detect the presence of the patient 63 within these zones. The innerzones 2, 4, 7, 9 are positioned to recognize motion at the edge of themain patient supporting surface of the bed 60 and/or beyond because theinner zones 2, 4, 7, 9 are adjacent to the left and right sides 65, 64of the bed 60, respectively. Various techniques for detecting motionwithin a zone are further discussed herein. An alert can be issuedand/or a patient fall risk status can be raised to summon interventionif motion is detected in one of the inner zones 2, 4, 7, 9.

It can be routine for a visitor (e.g., a health care professional orfamily member) to enter a room while a patient is on the bed and apatient monitoring system is monitoring. The motion of the visitor couldbe detected in any of the upper right inner zone 2, the lower rightinner zone 7, the upper left inner zone 4, and the lower right innerzone 9, thereby erroneously triggering an alert or escalating thepatient's fall risk status to a heightened patient risk state. However,the alert or fall risk state escalation can be prevented if motion isfirst detected in one or more other zones strategically placed tointercept the visitor before the visitor traverses an inner zone. FIG. 7illustrates such zones for intercepting visitors to avoid false alarmsand FIG. 9 shows a method for operating such a monitoring system.

FIG. 7 illustrates the boundaries of multiple monitoring zones. Themonitoring zones can be defined by an algorithm of a monitoring systembased on a user input, such as the left and right boundary designations70, 71. The monitoring zones can include upper right outer zone 1, upperright inner zone 2, upper patient zone 3, upper left inner zone 4, upperleft outer zone 5, lower right outer zone 6, lower right inner zone 7,lower patient zone 8, lower left inner zone 9, lower left outer zone 10,bottom zone 11, right top zone 12, and left top zone 13. It is notedthat the upper right outer zone 1, the upper right inner zone 2, theupper left inner zone 4, the upper left outer zone 5, the lower rightouter zone 6, the lower right inner zone 7, the lower left inner zone 9,and the lower left outer zone 10 can be referred to as side zonesbecause they are partially or wholly on the lateral sides (e.g., rightand left sides 64, 65) of the bed 60. It is noted that these inner zonesfurther do not extend beyond the top and bottom sides 66, 67 of the bed60. The bottom zone 11, the right top zone 12, and the left top zone 13can be referred to as end zones because they are substantially or whollybeyond the longitudinal ends (e.g., top and bottom sides 66, 67) of thebed 60. It is noted that these end zones are not within the lateralprojections of the right and left sides 64, 65 of the bed 60. The zonescan be defined to be along a single plane in space. In some embodiments,the plane can be aligned with the main patient supporting surface of thebed 60 on which the patient lies.

In some embodiments, the patient zones 3, 8 can be identified ascorresponding to the major planar support surface of the bed 60 by auser and/or by the monitoring system using object and/or surfacerecognition techniques. A patient zone, whether specifically monitoredor not monitored (e.g., because adjacent zones are monitored), cancorrespond to an elevated patient support surface from which a patientcould fall. The inner zones 2, 4, 7, 9, can then be automaticallydefined as extending adjacently along the edges of the patient zones 3,8 corresponding to the left and right sides 64, 65 of the bed 60.

Various rules can be used by an algorithm of a monitoring system todefine the monitoring zones. For example, a longitudinal dimension ofthe upper left inner zone 4 can be defined as extending parallel withthe longitudinal dimension 61 of the bed 60 as indicated by one or bothof the left and right boundary designations 70, 71. The longitudinaldimension of the upper left inner zone 4 can be defined to extend fromone end (e.g., the top end) of the right boundary designation 71 to amidpoint (e.g., the midline 75) of the right boundary designation 71. Awidth dimension of the upper left inner zone 4 can be defined asextending laterally outward from the right boundary designation 71(e.g., away from the left boundary designation 70) a predeterminednumber of pixels. The predetermined number of pixels may correspond witha distance, such as twelve inches. The upper left outer zone 5 can bedefined as adjacent to the upper left inner zone 4 (e.g., opposite theleft boundary designation 70). Each inner zone (e.g., upper right innerzone 2, lower right inner zone 7, and lower left inner zone 9) can beautomatically defined in a similar way as the upper left inner zone 4(e.g., each extending along one of the left or right boundarydesignations 70, 71 in a longitudinal dimension and having apredetermined width).

The upper left outer zone 5 can be defined to be coextensive with theupper left inner zone 4 along a longitudinal axis of the upper leftinner zone 4 such that the upper left outer zone 5 has the samelongitudinal dimension as the upper left inner zone 4. Further, a widthdimension of the upper left outer zone 5 can be defined to extendlaterally outward from the upper left inner zone 4 (e.g., away from theright boundary designation 71) a predetermined number of pixels. Thepredetermined number of pixels may correspond with a distance, such astwelve inches. Each outer zone (e.g., upper right outer zone 1, lowerright outer zone 6, and lower left outer zone 10) can be automaticallydefined in a similar way as the upper left outer zone 5 (e.g., eachextending along a respective one of the inner zones in a longitudinaldimension and having a predetermined width). Although FIG. 7 showsmultiple inner zones (and multiple corresponding outer zones) to coverthe whole longitudinal dimension 61 of the patient area, a single innerzone (and a corresponding single outer zone) can be provided for eachright and left sides 65, 64 of the bed 60 to extend along the entirelongitudinal dimension of the bed 60. Alternatively, three or more innerzones can be provided on each lateral side to cover the longitudinaldimension of the bed 60.

The bottom zone 11 can be defined in various ways. For example, thelongitudinal dimension of the bottom zone 11 can be orientatedorthogonal to one or both of the left and right boundary designations70, 71 and/or parallel with one or both of the top and bottom boundarydesignations 72, 73. The longitudinal dimension of the bottom zone 11can be defined as extending a predetermined number of pixels to the leftof the lower right inner zone 7 and to the right of the lower left innerzone 9. Defining the bottom zone 11 as extending laterally past each ofthe lower right inner zone 7 and the lower left inner zone 9 insulatesat least the lower sides of the inner zones such that a visitorapproaching the bed 60 from the near side of the room would traverseeither the bottom zone 11 or one of the outer zones before traversingone of the inner zones. Although not illustrated in FIG. 7, thelongitudinal dimension of the bottom zone 11 can be defined such thatthe left side of the bottom zone 11 aligns with the left side of thelower right inner zone 7 and the right side of the bottom zone 11 alignswith the right side of the lower left inner zone 9. Other dimensions forthe bottom zone 11 are also contemplated.

The width of the bottom zone 11 can be defined as extending apredetermined number of pixels away from the bottom boundary designation73 or from the bottoms of the lower right inner zone 7 and the lowerleft inner zone 9, for example. In some cases, a buffer area is providedbetween the bottom boundary designation 73 and the bottom zone 11. Forexample, a top boundary of the bottom zone 11 may be separated from thebottom boundary designation 73 by a predetermined number of pixels. Thepredetermined number of pixels can correspond to a distance, such as 6inches. The predetermined number of pixels (or other measure ofdistance) can provide a buffer area between the lower patient zone 8(where motion not indicative of a fall may be expected) and the bottomzone 11 that is monitored for motion to disarm the monitoring system.This buffer can allow the patient to move within the patient zone, andeven deviate outside of the patient zone in a downward direction that isunlikely to result in a fall, without either disarming the monitoringsystem (e.g., as with motion in the bottom zone 11) or triggering a fallalert or fall risk escalation (e.g., as with motion in the innermonitoring zones). In some embodiments, the buffer area is not monitoredfor motion. In some embodiments, motion detected within the buffer areamay not result in any consequential action (e.g., no fall alert, fallrisk state escalation, or alarm suspension). In various embodiments, nobuffer area is provided between the patient zone (e.g., the upper andlower patient zone 3, 8) and the inner zones (e.g., upper left innerzone 4, upper right inner zone 2, lower right inner zone 7, and lowerleft inner zone 9) because a patient is most likely to fall from theleft or right 64, 65 sides of the bed 60 and patient motion within theinner zones is therefore assumed to be indicative of a heightened fallrisk. In any case, no monitoring zone that triggers an alarm is placedbetween the bottom side 67 of the bed 60 and the bottom zone 11, whichis different from the arrangement on the lateral sides of the bed 60wherein the inner zones 2, 4, 7, 9 (which can trigger an alarm) arelocated directly between the right and left sides 65, 64 of the bed 60and the outer zones 1, 6, 5, 10, respectively. However, various otherembodiments may not be so limited.

The top zones 12, 13 can be defined in various ways. The right top zone12 can be defined such that the lower edge of the right top zone 12 isadjacent to the top edges of the upper right outer zone 1 and the upperright inner zone 2. The width of the right top zone 12 can becoextensive and equal to the widths of the upper right outer zone 1 andthe upper right inner zone 2 combined. As such, the right edge of theright top zone 12 can be aligned with the right edge of the upper rightouter zone 1 and the left edge of the right top zone 12 can be alignedwith the left edge of the upper right inner zone 2. The left top zone 13can be defined as having the same relationship with respect to the upperleft inner zone 4 and the upper left outer zone 5 as the right top zone12 has with the upper right outer zone 1 and the upper right inner zone2. Alternatively, the inner edges of the top zones 12, 13 can extendalong and adjacent to the top side 66 of the bed 60. In someembodiments, a single top zone is provided, the single top zone havingthe same configuration and dimensions as the bottom zone 11 except thatthe top zone is positioned along the top side 66.

Different rules for motion detection can be used for the inner zones(e.g., upper right inner zone 2, upper left inner zone 4, lower rightinner zone 7, and lower left inner zone 9) as compared to the outerzones (e.g., upper right outer zone 1, lower right outer zone 6, upperleft outer zone 5, and lower left outer zone 10) and the end zones(e.g., the top zone 12 and the bottom zone 11). For example, motiondetected in the inner zones 2, 4, 7, or 9, along where a patient is mostlikely to fall, can trigger a fall alert and/or escalate a fall riskstate. However, the fall alert is not triggered or the fall risk is notescalated if motion is first detected in any of the outer zones or thebottom zone before motion is detected in one of the inner zones. In suchcases, the motion first detected in an outer zone 1, 5, 6, 10, or bottomor top zone 11, 12, 13 is most likely to be associated with a visitor.If motion is detected in an outer zone 1, 5, 6, 10, or bottom or topzone 11, 12, 13 before motion is detected in an inner zone 2, 4, 7, or9, then a deactivation timer can start counting. The deactivation timercan temporarily suspend one or more functions to prevent motion in oneor more of the inner zones 2, 4, 7, or 8, which would otherwise triggera fall alert or raise a patient risk status, from causing the fall alertor the fall risk state escalation to be issued as long as the timer iscounting. The timer can count for a predetermined amount of time toallow the visitor to interact with the patient 63. The timer can bereset or extended based on additional motion being detected within oneor more of the outer or end zones, indicating continued motion. In somecases, motion detected within an inner zone also restarts or extends thecounting of the deactivation timer if the motion was detected while thedeactivation timer was already counting. At the expiration of the timeperiod (e.g., 30 seconds counted by the timer), the inner zones arere-armed such that motion detected within these zones can trigger a fallalert or fall risk state escalation.

In this way, one or more zones of a first type of zone (e.g., the innerzones) strategically positioned to detect motion associated with a fallcan be monitored to trigger a fall alert and/or escalate a fall riskstate while one or more zones of a second type of zone (e.g., outer andend zones) strategically positioned to detect motion of visitors beforethe visitors traverses one of the first zones can be monitored totemporarily disarm the system to prevent the erroneous issuing of thefall alert and/or escalation of the fall risk state.

While the outer zones may reduce false alarms and premature fall riskstate escalation by intercepting visitors before they can traverse aninner zone along the side of the bed 60, the outer zones 1, 5, 6, 10alone (i.e. without the bottom or top zones 11, 12, 13) may stillprovide a path where a visitor can traverse an inner zone withoutcrossing an outer zone, even though no inner zones (that trigger analarm) were placed along the top and bottom sides 66, 67 of the bed 60.For example, a visitor entering through the door 79 may stay below theouter zones (from the perspective of the camera) before approaching thebed 60 from the bottom. The inventors of the subject matter of thepresent disclosure have determined in testing that disarming themonitoring system upon detection of motion in the bottom zone 11 cansubstantially reduce false alarms as compared to embodiments using outerzones 1, 5, 6, 10 alone to intercept visitors. Unlike the left and rightsides 64, 65 of the bed 60, no monitoring zone that can trigger a fallalert and/or fall risk state escalation extends along the bottom side 67or the top side 66 of the bed 60. This is because a patient is unlikelyto fall from the bottom side 67 or the top side 66 of the bed 60, but avisitor is likely to approach the bed 60 from the direction of thebottom side 67 (e.g., when coming through door 79) or the top side 66.As such, different types of monitoring zones, and various layers ofmonitoring zones, can be provided on different sides of the bed 60 by amonitoring system to strategically account for the different types ofmotion expected in the different zones surrounding the bed 60 toidentify occurring and/or imminent falls while minimizing false alarms.

FIG. 7 further illustrates a remote zone 80. Various embodiments mayinclude one or more remote zone 80. A monitoring system can monitor formotion within the remote zone 80 and can further take any stepsdescribed herein for when motion is detected in an outer or end zone.For example, if motion is detected in the remote zone 80, then themonitoring system can start a deactivation timer and suspends one ormore functions during the counting of the timer to prevent motion in oneor more of the inner zones 2, 4, 7, 9 from causing a fall alert or afall risk state escalation.

The remote zone 80 is strategically placed to intercept visitors beforethe visitors traverse one of the inner zones 2, 4, 7, 9. In FIG. 7, theremote zone 80 is placed to intercept a visitor entering the roomthrough the door 79. A remote zone could additionally or alternativelybe placed at a location at which a visitor is likely to occupy, such asnext to a chair, a sink station, a supply station, or a computerstation.

A remote zone is a zone that is not proximate an elevated patientsupport surface for which monitoring is taking place to detect activityindicative of a patient fall, wherein motion detected within the remotezone suspends one or more functions of the monitoring system. As shown,the remote zone 80 does not share a boundary with the patient zones 3, 8(covering the patient support surface of the bed 60), inner zones 2, 4,7, 9, or the outer zones 1, 5, 6, 10. Moreover, a significant gap (e.g.,of one or more feet) can exist between the remote zone 80 and each ofthe patient zones 3, 8, the inner zones 2, 4, 7, 9, and the outer zones1, 5, 6, 10.

The remote zone 80, or any remote zone, can be defined in various ways.In some embodiments, a user viewing a screen showing a frame of apatient room can provide a plurality of inputs corresponding to thelocations of four corners of where the user desires the remote zone 80to be located. An algorithm can then define a quadrilateral shape basedon the four indicated corners. A user may additionally or alternativelyprovide an input of a line or shape with which the monitoring system candefine a remote zone. Monitoring can then take place within the remotezone 80 to detect motion within the remote zone 80.

FIG. 8 illustrates a flow chart of a method for setting up a monitoringsystem to monitor a patient. The method includes receiving 50 a frame ofa patient area. The frame can be an image generated by the camera 18 andcan be received 50 by the computing system 17 of FIGS. 1-2. The framecan be displayed on a screen at the monitoring station 15. The patientarea can correspond to any area associated with a patient and/or whereincreased risks to the patient are anticipated. Such areas can include abed, a chair, a wheelchair, a tub, a shower, and/or an entryway.

The method can further include receiving 51 an input indicating alocation. The input may be provided by a healthcare professional at themonitoring station 15 with a user interface (e.g., with a touch screenor mouse). The indicated location can correspond to an area occupied bythe patient and/or a risk to the patient. In some cases, a healthcareprofessional can indicate one or more boundaries associated with fallrisk, such as the left and right sides of a bed. The input may includedesignations of the locations of the left side 64 and the right side 65of the bed 60 as displayed on a screen, such as one or both of the leftboundary designation 70 and the right boundary designation 71.Additionally or alternatively the user input can indicate the top side66 and the bottom side 67 of the bed 60 such as with the top boundarydesignation 72 and the bottom boundary designation 73. The input mayinclude designations of the locations of the four corners of a bed. Analgorithm can then define a quadrilateral shape based on the fourindicated corners, such as by linearly connecting the four corners.Boundary designations 70-73 can be automatically placed along the sides64-67 of the bed 60 based on the identification of the four corners.Still other designations indicating one or more locations of a patientarea are possible. In some implementations, the patient area can be abed, a chair, or other elevated patient support surface. In some cases,only part of the patient area is indicated by the user input and therest of the patient area is defined automatically (e.g., byinterpolating the top and bottom boundaries of a bed between thedesignated left and right sides of the bed).

It is noted that a patient area may be automatically identified througha pattern recognition procedure implemented in the monitoring system insome embodiments such that a user input is not required to define thearea, but user input may be needed to confirm the automatically definedboundaries. For example, an elevated patient support surface can beidentified automatically using an algorithm as described in commonlyowned U.S. Provisional Patent Application No. 61/792,204, filed on Mar.15, 2013, titled SYSTEMS AND METHODS FOR DYNAMICALLY IDENTIFYING APATIENT SUPPORT SURFACE AND PATIENT MONITORING, which is incorporatedherein by reference in its entirety. Boundary designations 70-73 can beautomatically placed along the sides 64-67 of the bed 60 based on theidentification of the elevated patient support surface.

One or more zones can be defined 52 based on the received 51 user input.For example, one or more zones within and/or outside of a boundarydesignation can be defined by an algorithm. The zones can be in partmanually defined 51 or can be automatically defined 51 wholly by thecomputing system 17. The one or more zones can correspond with areas ofincreased risk to a patient, such as areas adjacent to and/or over theside of the bed (e.g., as a virtual bedrail). In some embodiments, theone or more zones correspond to areas where patient motion is expectedand/or where patient motion can be indicative of dangerous or otherwiseunwanted activity. In some cases, a plurality of zones can be defined 52to cover the bed and/or extend along the bed or other patient area.

Various rules can be used by an algorithm of a monitoring system todefine 52 the one or more zones. For example, a longitudinal dimensionof a zone can be defined 52 as extending parallel with the longitudinaldimension of a bed as indicated by the received 51 input. A widthdimension of a zone can be defined as extending outward from theboundary designations (e.g., away from the bed) for a calculateddistance. The distance can be calculated in pixels as a unit of length.The width of each of the inner and outer zones can be determined basedon a relationship to a dimension of the patient area. For example, thewidth of the inner zone 2 can be 1:5 of the length of the right boundarydesignation 71 or 1:5 of the length of the top boundary designation 72.The width of the outer zone 1 can be 1:2 of the length of the rightboundary designation 71 or 2:3 of the length of the top boundarydesignation 72. In some embodiments, the width of the outer zone 1 canbe 45% of the length of the right boundary designation 71. In theseexamples, the width of the outer zones 1, 5, 6, 10 is greater than thewidth of the inner zones 2, 4, 7, 9 by a predetermined ratio because thewidths of each zone is based off of a common reference (e.g., the lengthof the right boundary designation 71 or the length of the top boundarydesignation 72). However, the side zones are illustrated in FIG. 7 ashaving the same width. The zones can be defined 52 in dimensions ofpixels. The width of the bottom zone 11, measured vertically in theembodiment of FIG. 7, can be 1:5 (or alternatively 22.5%) of the lengthof the bottom boundary designation 73. In some embodiments, the lengthof the bottom zone 11 can be determined by setting the longitudinal endsof the bottom zone 11 as aligned with the midpoints of the widths of thelower outer zones 6, 10, although it is noted that such a configurationis not shown in the embodiment of FIG. 7. Because the widths of thelower outer zones 6, 10, as well as the location of the midpoints alongthese widths, are set based on a relationship to the length of adesignated boundary (e.g., the right designated boundary 71), and thelength of the bottom zone 11 can be set based on the width of the lowerouter zones 6, 10, the length of the bottom zone 11 can be set based onthe length of the designated boundary. The widths of the top zones 12,13 can be set as being the same as the width of the bottom zone 11. Thelengths of the top zones 12, 13 can be set based on the longitudinalends of the top zones 12, 13 respectively aligning with the outer sideof the outer zone 1, 5, and the inner side of the inner zones 2, 4, orthe boundary designations 71, 70.

A width dimension of a zone can be defined as extending outward from theboundary designations (e.g., away from the bed) for a predeterminednumber of pixels. The predetermined number of pixels may correspond witha distance, such as twelve inches.

The defined 52 zones can include inner, outer, and end zones, forexample. Such inner zones can correspond to the inner zones 2, 4, 7, 9previously discussed, or other inner zones adjacent a patient area. Theouter zones can correspond to the outer zones 1, 5, 6, 10 or other zonesthat are not adjacent a patient area. The end zones can be the bottomzone 11 and/or the top zone 12 or other zone that is adjacent to apatient area/or an inner zone. Other zones could additionally oralternatively be defined 52. In some embodiments, a remote zone can bedefined, such as remote zone 80. It is noted that the inner zones, theouter zones, and the end zones can be defined automatically by amonitoring system based on the received 51 input indicating a locationof the patient area. A user may make adjustments to automaticallydefined zones or confirm the arrangement of the zones with the userinterface.

The method of FIG. 8 further includes monitoring 53 the defined 52zones. Monitoring 53 can include executing a motion detection algorithmto detect motion in any of the defined 52 zones. In some embodiments,areas of a frame that are not within a defined 52 zone are not monitored53 for motion (e.g., the motion detection algorithm is not run to detectmotion in areas outside of a zone). Motion in the patient zones 3, 8 maybe indicative of normal patient movement and may be documented (e.g., aframe or indication of movement can be time stamped and saved inmemory). Motion detected within any of an inner zone 2, 4, 7, or 9 canindicate that the patient is at least partially off the bed 60 and atrisk of falling. Motion within any of the outer zones 1, 5, 6, 10,bottom or top zones 11, 12, 13, and/or remote zone 80 can indicate thepresence of a visitor, which deactivate the system from issuing an alertand/or raising the patient fall risk status as discussed herein.Monitoring 53 of the zones can allow particular discriminationalgorithms to be run using the pixels of the zones to identify patternsor other indication of a patient event. For example, an algorithm cancompare optical characteristics of the pixels of a zone betweensequential frames to determine whether the optical characteristic of thezone changed, the change indicative of patient movement. Varioustechniques for detecting motion from optical characteristics are furtherdiscussed herein.

FIG. 9 illustrates a flowchart of a method for monitoring a patient. Thesteps of the method can be automatically performed by a monitoringsystem having a processor and memory storing program instructionsexecutable by the processor to cause the monitoring system to implementthese and/or any other steps referenced herein. The method of monitoringof FIG. 9 can correspond to the monitoring 53 step of FIG. 8, such thatthe method of FIG. 8 concerns setting up monitoring zones and FIG. 9concerns monitoring those zones in a way the minimizes false alarms. Themethod includes receiving 91 a plurality of frames of a patient area.The frames can be a chronological series of frames generated by thecamera 18 and transmitted to a computing system in sequence, wherein themonitoring steps 91-96 of the method are performed for the reception ofeach respective frame of the chronological series. Accordingly, themonitoring steps 91-96 of FIG. 9 can represent one iteration of a cycle,the cycle being repeated for each frame received.

The method further includes monitoring 92 inner, outer, and end zones.The zones can be defined 52 in the manner of the method of FIG. 8 and/oras elsewhere shown and/or described herein. The monitored 92 inner zonescan correspond to inner zones 2, 4, 7, or 9. The monitored 92 outerzones can correspond to outer zones 1, 5, 6, 10. The monitored 92 endzones can correspond to bottom zone 11 and/or top zones 12, 13. Howevervarious embodiments are not so limited. One or more remote zones (e.g.,remote zone 80) may also be monitored 92. The zones can be monitored 92for changes in one or more optical characteristics, as further discussedherein, between different frames of the chronological series. Changes inthe optical characteristics within a zone between frames of a series canindicate motion within the zone.

During monitoring 92 of the zones, a series of checks can be performed.The checks may be performed periodically or continuously. The firstcheck 93 can determine whether motion was detected in any of the outeror end zones. The first check 93 may additionally or alternativelydetermine whether motion was detected in a remote zone. If motion is notdetected in an outer zone or the end zone at check 93 (or optionally aremote zone), but motion is detected in an inner zone at check 95, thenthis scenario can indicate that a patient is moving outside of thepatient zone and that a fall may be occurring or imminent. In such acase, one or both of a fall alert can be issued or a fall risk state canbe raised 96.

Returning to the check 93 of the outer and end zones, if motion wasdetected in any of the outer or end zones (or optionally a remote zone),then the method can suspend 94 one or more functions. The triggering ofthe suspension 94 period can correspond to initiation of a deactivationtimer that counts for a predetermined period of time. The suspension 94period ends when the count of the deactivation timer expires. The one ormore functions are suspended 94 during the counting of the deactivationtimer and the one or more functions that were suspended 94 arere-activated when the timer completes the count (e.g., after countingfor the predetermined period of time). The predetermined period of timemay be 30 seconds, 60 seconds, or some other time period.

During the suspension 94 period, various actions can be taken orsuspended. It is noted that motion detected within one of the outer orend zones may trigger the generation of a notice from a user interfaceindicating that the monitoring system is being disarmed. In someembodiments, a user may be able to provide an input that overrides thedisarming such that the one or more functions are not suspended 94. Itis noted that motion detected within the outer or end zones will nottrigger the issuing of a fall alert or the raising of a fall risk state.

The one or more suspended 94 functions can include the monitoring 92 ofsome or all of the zones. For example, monitoring 94 of the inner zonesmay be suspended 94, which would prevent the issuing of an alert or theraising of a fall risk state, as further discussed herein.Alternatively, the motion check 95 may be suspended 94, the suspension94 of the motion check 95 allowing the monitoring 62 of all zones tocontinue but preventing the algorithm from issuing a fall alert orraising a fall risk state 96. In some cases, monitoring 92 and checks93, 95 are not suspended 94 but the monitoring system suspends 94 theissuing of an alert or the raising of a fall risk state 96. For example,a monitoring system may only be disarmed from issuing a fall alert orraising a fall risk state during a suspension 94 period while monitoring92 and documentation of events continues. In some embodiments, thesuspension 94 period can be restarted or the period can be extended ifadditional motion is detected in any of the outer zones, the end zones,and/or inner zones while the deactivation timer is already counting,assuming that monitoring 92 continues to be performed in at least thesezones during the suspension 94 period.

In some embodiments, the monitoring system issues the alert or raisesthe fall risk state 96 based on motion being detected within one of theinner zones only if motion was also previously or simultaneouslydetected within one of the patient zones 3, 8 of the patient area. Forexample, if isolated motion is only detected in one of the inner zones2, 4, 7, 9, without preceding motion being detected within one of thepatient zones 3, 4, then it may be assumed that the motion within theinner zones 2, 4, 7, 9 was erroneously detected (e.g., the patient wasnot actually within one of the inner zones 2, 4, 7, 9). As such,monitoring 92 may include monitoring for motion within the patient zones3, 4 and only if motion was precedingly detected within one of thepatient zones 3, 4 (e.g., within a predetermined amount of time, such asfive second, or within a predetermined number of previous frames, suchas 25) will motion detected within one of the inner zones 2, 4, 7, 9cause the monitoring system to issue the alert or raise the fall riskstate 96. Optionally, motion detected within one of the inner zones 2,4, 7, 9 may cause the monitoring system to issue the alert or raise thefall risk state 96 if motion is also simultaneously detected (e.g., inthe same frame) within the patient zones 3, 4. However, in some otherembodiments, precursor or simultaneous motion within the patient zones3, 4 is not required for motion detected within one of the inner zones2, 4, 7, 9 to cause the monitoring system to issue the alert or raisethe fall risk state 96.

It is noted that the checks 93 and 95 are ordered such that the check 93for motion in the outer or end zones is performed before the check 95for motion in the inner zones. While the checks 93 and 95 may bechronologically performed in that order for each frame, or may beperformed simultaneously or in reverse order, the check 95 for motionwithin the outer or end zones can be prioritized such that regardless ofwhether motion occurs within one of the inner zones from a frame, motiondetected within one of the outer or end zones for the same frame disarmsthe monitoring system to prevent the issuing of the fall alert or theraising of the fall risk state 96. The reason for this is that,dependent on the rate of frame generation, rapid visitor motion may befirst detected in multiple zones in a single frame (e.g., motion isfirst detected in both zones 6 and 7 in a frame). As such, it may bepreferable to assume that such rapid motion traversing multiple zones isfrom a visitor and not indicative of a fall as long as motion isdetected in one of the outer or bottom zones.

Various techniques can be employed to detect patient activity in amonitored zone. For example, some techniques can be based on changes inpixel luminance and/or color between frames, the change indicative ofthe patient having moved within the zone between the times that theframes were generated. Each pixel of a frame can be assessed to measureluminance, color, and/or other optical characteristics. The luminancecharacterizes the intensity of the light associated with the pixel Onetechnique for measuring luminance includes categorizing the intensity ofeach pixel along an 8-bit grayscale, where 0 can be the lowest possibleintensity level (i.e. darkest) and 255 can be the highest possibleintensity level (i.e. brightest). Luminance can be particularly usefulbecause luminance can be measured in dark environments, such as atnight. Luminance and/or color can be used for motion detection byidentifying changes in the luminance or color of a zone over time. Theluminance of a zone may change over time (e.g., between sequentialframes) because the reflectance of the surfaces within the zone canchange due to movement of the surfaces. For example, a patient's arm canmove into a zone, thereby changing the luminance of the zone to bedarker or lighter. Comparisons between a luminance-based metric of azone between frames can determine whether the change in luminance isindicative of patient movement within the zone. For example, the changein luminance may be compared to a threshold, the thresholddistinguishing small changes in luminance unlikely to be associated withpatient movement (e.g., noise) and larger changes in luminance likely tobe from patient movement. Changes in color or other opticalcharacteristic can likewise be indicative of patient movement.

While changes in luminance and/or color can be identified by directlycomparing pixel characteristic values from consecutive frames for aparticular zone, additional or alternative techniques can be employed todetect changes between frames. For example, another metric is the numberof edges within a zone. Edges can be detected by analyzing the contrastin luminance and/or color between neighboring pixels. High contrastindicates an edge while low contrast indicates the lack of an edge.Summing the edges detected within a zone can be useful in motiondetection because the number of edges within a zone changes from oneframe to the next if motion is occurring within the zone. As such,monitoring for motion can include determining whether a change in thenumber of edges detected in a zone between two frames exceeds a zonethreshold.

In some embodiments, pixel values may be assessed relative to abackground luminance. The background luminance value is a measure of theluminance (or other characteristic) of most or all pixels of the frame.A pixel luminance value can be calculated by subtracting a backgroundluminance value from the luminance value measured for a pixel to cancelout global changes in lighting that affect the whole frame. Variousaggregating techniques can be used to calculate a value representing thebackground luminance of a frame, such as average, median, mode,variance, or standard deviation, among others, of most or all pixels ofthe frame and/or a series of frames. In some cases, the backgroundluminance can be calculated only from pixels of a specific selection ofthe frame that is not occupied by the patient or otherwise part of azone monitored for movement (e.g., an area of the floor and/or wall).

Motion within a particular zone can be detected by comparing a firstmeasure of an optical characteristic of the particular zone from a firstframe to a second measure of an optical characteristic of the particularzone from a second frame, the second frame generated after the firstframe. For example, for each pixel in the zone, a difference inluminance between the measured luminance of the pixel and a backgroundluminance value can be calculated. The background luminance value orother background optical characteristic value can be calculated based onthe current frame and/or previous frames. The absolute value can be thetaken of the difference between the measured luminance of the pixel andthe background luminance value such that positive and negativedifferences can be equally valued. For example, the background luminancevalue may be 150 on the 8-bit grayscale, while a first pixel has aluminance of 140 and a second pixel has a luminance of 165. Thecalculated difference associated with the first pixel can be 10(assuming the absolute value is taken) and the calculated 91 differenceassociated with the second pixel can be 15.

A zonal value can then be calculated for the zone by aggregating thedifferences in the optical characteristic of most or all of the pixelsof the zone as compared to the background optical characteristic value.For example, the calculated difference between the measured luminanceand the background luminance value for each pixel of the zone can beaggregated for all pixels of the zone to calculate the zonal luminanceas the zonal value. The zonal luminance can represent a measure of theoverall luminance of a zone. The measured values of the opticalcharacteristics of the pixels of the zone can be aggregated to calculatethe zonal value by determining the sum, average, median, mode, standarddeviation, or other statistical metric from the difference in theoptical characteristic between of the pixels of the zone and thebackground optical characteristic value. In the case of summing, andcontinuing with the example provided above, the first and the secondpixels can be in the same zone, and as such can be summed to 25. Furtherdifference values from the same zone can be aggregated (e.g., averaged)to calculate the zonal value. A plurality of zonal values can becalculated for a plurality of zones such that each zone has acorresponding zonal value for each frame.

Zonal values for the same zone but from different frames can be comparedto determine whether the optical characteristic of the zone has changedbetween the frames. The change in optical characteristic of the zone canbe indicative of movement within the zone, which can serve as the basisfor raising a patient fall risk state, issuing an alert, disarming thesystem, or taking some other action. For example, a current frame (i.e.the most recently generated frame) is evaluated by calculating a zonalluminance for a particular zone and then comparing the zonal luminanceto the zonal luminance for the same zone of a previously generated frame(e.g., the penultimate frame) or an aggregate zonal luminance value. Theaggregate zonal luminance (or other aggregate zonal value) can be theaverage or variance of a plurality of zonal luminance values calculatedfrom pixels of the zone from a plurality of previously generated frames.For example, a running average of zonal luminance can be calculated froma predetermined number (e.g., five) of previously generated frames, andthe zonal luminance value of the current frame can be compared to therunning average or other measure of aggregate zonal luminance todetermine whether the current frame reflects a change indicative ofmotion within the zone. The difference in zonal value between differentframes can be compared to a zone threshold to determine whether thedifference in zonal value between frames exceeds the zone threshold. Thezone threshold can represent the difference between minor changes in theoptical characteristic due to noise and larger changes in the opticalcharacteristic that are due to movement. The zone threshold can be setfor each zone and may be the same or different for the different zones.The zone threshold may be a predetermined amount. For example, the zonethreshold may be 2 on the 8-bit grayscale previously described. If thezone threshold is exceeded, then an indication of motion can begenerated. The indication may comprise designating the zone as active,representing a notification of an event on a screen, raising a patientfall state risk, issuing an alert (e.g., an alarm to summonintervention), disarming the system, and/or taking any step referencedherein.

While the preceding example and other example discusses luminance as theoptical characteristic used to detect motion, various other opticalcharacteristics can be used in place of, or in addition to, luminance inany of the embodiments referenced herein. These optical characteristicscan be compared to previously calculated values for the same zone todetect motion as described herein. An optical characteristic can bemeasured based on the intensity or degree of content. An opticalcharacteristic can include chrominance. Optical characteristics caninclude color content, or one or more particular components of color(e.g., red, green, blue, and/or other color). Color can be measured byany measure of color space. An optical characteristic can be the numberof edges of a zone. Accordingly, the term “luminance” can be replaced by“optical characteristic”, “color”, “number of edges”, or other term inany embodiment discussed herein. Various techniques for detecting motionwithin a zone, which can be implemented in the embodiments describedherein, are discussed in commonly owned U.S. Provisional PatentApplication No. 61/753,991, filed on Jan. 18, 2013, titled PATIENT VIDEOMONITORNIG SYSTEMS AND METHODS HAVING DETECTION ALGORITHM RECOVERY FROMUNPREDICTABLE CHANGES IN GLOBAL ILLUMINATION, which is incorporatedherein by reference in its entirety.

The flowchart and block diagrams in the FIGS. of the present disclosureillustrate the architecture, functionality, and operation of somepossible implementations of systems, methods, and computer programproducts according to various embodiments of the present disclosure. Inthis regard, each step in the flowchart or arrangement of blocks mayrepresent a component, module, segment, or portion of code, whichcomprises one or more executable instructions for implementing thespecified logical function(s). It should also be noted that, in somealternative implementations, the functions noted in the steps may occurout of the order noted in the FIGS. or as otherwise described. Forexample, two steps shown or discussed in succession may, in fact, beexecuted substantially concurrently, or the steps may sometimes beexecuted in the reverse order, depending upon the functionalityinvolved.

It is noted that reception of a frame (e.g., by a computing system froma camera) does not necessarily mean reception of all of the data of theframe sufficient to reconstruct the entire frame. Rather, reception ofthe frame can include reception of representative data (e.g., luminanceinformation) that allows for calculation of the background luminance andother values for performing the functions described herein.

The techniques described in this disclosure, including those describedin association with FIGS. 1-9 and those attributed to a monitoringsystem, a computing system, a processor, and/or control circuitry,and/or various constituent components, may be implemented wholly or atleast in part, in hardware, software, firmware or any combinationthereof. A processor, as used herein, refers to any number and/orcombination of a microprocessor, a digital signal processor (DSP), anapplication specific integrated circuit (ASIC), a field-programmablegate array (FPGA), microcontroller, discrete logic circuitry, processingchip, gate arrays, and/or any other equivalent integrated or discretelogic circuitry. A “computing system” as used herein refers to at leastone of the foregoing logic circuitry as a processor, alone or incombination with other circuitry, such as memory or other physicalmedium for storing instructions, as needed to carry about specifiedfunctions (e.g., processor and memory having stored program instructionsexecutable by the processor for defining zones, monitoring the zones formotion, and issuing an alert or suspending one or more functions toprevent the alert from being issuing based on in which type of zonemotion is first detected). The functions referenced herein and thosefunctions of FIGS. 1-9, may be embodied as firmware, hardware, softwareor any combination thereof as part of a computing system specificallyconfigured (e.g., with programming) to carry out those functions, suchas in means for performing the functions referenced herein. The stepsdescribed herein may be performed by a single processing component ormultiple processing components, the latter of which may be distributedamongst different coordinating devices. In this way, the computingsystem may be distributed between multiple devices, including part of acamera and part of a computer. In addition, any of the described units,modules, or components may be implemented together or separately asdiscrete but interoperable logic devices of a computing system.Depiction of different features as modules or units is intended tohighlight different functional aspects and does not necessarily implythat such modules or units must be realized by separate hardware orsoftware components and/or by a single device. Rather, functionalityassociated with one or more module or units, as part of a computingsystem, may be performed by separate hardware or software components, orintegrated within common or separate hardware or software components ofthe computing system.

When implemented in software, the functionality ascribed to a computingsystem may be embodied as instructions on a physically embodiedcomputer-readable medium such as RAM, ROM, NVRAM, EEPROM, FLASH memory,magnetic data storage media, optical data storage media, or the like,the medium being physically embodied in that it is not a carrier wave,as part of the computing system. The instructions may be executed tosupport one or more aspects of the functionality described in thisdisclosure.

The particular embodiments described below are not intended to limit thescope of the present disclosure as it may be practiced in a variety ofvariations and environments without departing from the scope and intentof the invention. Thus, the present disclosure is not intended to belimited to the embodiments shown, but is to be accorded the widest scopeconsistent with the principles and features described herein. Variousmodifications and additions can be made to the exemplary embodimentsdiscussed without departing from the scope of the present invention. Forexample, while the embodiments described above refer to particularfeatures, the scope of this invention also includes embodiments havingdifferent combinations of features and embodiments that do not includeall of the described features. Accordingly, the scope of the presentinvention is intended to embrace all such alternatives, modifications,and variations as fall within the scope of the claims, together with allequivalents thereof.

What is claimed is:
 1. A system for monitoring a patient on a patientsupport surface, the system comprising: a camera configured to output aplurality of video frames of a patient room; and a computing systemconfigured to: receive the plurality of video frames from the camera;define a plurality of zones based on the plurality of video frames ofthe patient room, the plurality of zones comprising first zones thatextend adjacently along a boundary outside of a patient area, and secondzones that extend adjacently along the first zones; monitor theplurality of video frames for motion within each of the plurality ofzones; in response to a first motion being detected in the first zonesbefore the first motion is detected in the second zones, issue an alertwith a user interface; and in response to a second motion being detectedin the second zones before the second motion is detected in the firstzones, disarm issuance of the alert.
 2. The system of claim 1, whereinthe computing system is configured to start a deactivation timer thattemporarily suspends triggering of the alert upon the disarmament of theissuance of the alert.
 3. The system of claim 2, wherein the computingsystem is configured to re-arm the triggering of the alert in responseto a third motion being detected in the first zones before the thirdmotion is detected in the second zones.
 4. The system of claim 1,wherein the computing system is configured to monitor the plurality ofvideo frames for motion within a remote zone that is not proximate tothe plurality of zones.
 5. The system of claim 4, wherein the computingsystem is configured to: output an image of a frame of a patient roomfor display on a screen of the user interface based on at least one ofthe plurality of video frames; and receive an indication of at least onelocation within the patient room from an input of the user interface,wherein the remote zone is defined based on the indication of the atleast one location.
 6. The system of claim 4, wherein the computingsystem is configured to in response to a third motion being detected inthe remote zone, disarm issuance of the alert.
 7. The system of claim 1,wherein the computing system is configured to in response to the firstmotion being detected in the patient area before the first motion isdetected in the first zones, issue the alert with a user interface. 8.The system of claim 1, wherein the computing system is configured toreceive an indication of at least one location within the patient roomfrom an input of the user interface, wherein one or more boundariesassociated with heightened patient risk state are defined based on theindication of the at least one location.
 9. The system of claim 1,wherein the computing system is configured to issue the alert toindicate the heightened patient risk state by generating one or both ofa sound with a speaker of the user interface and a visible notificationwith a light or a screen.
 10. A method for monitoring a patient in apatient support surface, the method comprising: receiving, at acomputing system, a plurality of video frames of a patient room from acamera; defining, by the computing system, a plurality of zones based onthe plurality of video frames of the patient room, the plurality ofzones comprising first zones that extend adjacently along a boundaryoutside of a patient area, and second zones that extend adjacently alongthe first zones; monitoring, by the computing system, the plurality ofvideo frames for motion within each of the plurality of zones; inresponse to a first motion being detected in the first zones before thefirst motion is detected in the second zones, issuing an alert by thecomputing system; and in response to a second motion being detected inthe second zones before the second motion is detected in the firstzones, disarming issuance of the alert by the computing system.
 11. Themethod of claim 10 further comprising starting a deactivation timer thattemporarily suspends triggering of the alert upon the disarmament of theissuance of the alert.
 12. The method of claim 11 further comprisingre-arming the triggering of the alert in response to a third motionbeing detected in the first zones before the third motion is detected inthe second zones.
 13. The method of claim 10 further comprisingmonitoring the plurality of video frames for motion within a remote zonethat is not proximate to the plurality of zones.
 14. The method of claim13 further comprising: outputting an image of a frame of a patient roomfor display on a screen of the user interface based on at least one ofthe plurality of video frames; and receiving an indication of at leastone location within the patient room from an input of the userinterface, wherein the remote zone is defined based on the indication ofthe at least one location.
 15. The method of claim 13 further comprisingin response to a third motion being detected in the remote zone,disarming issuance of the alert.
 16. The method of claim 10 furthercomprising in response to the first motion being detected in the patientarea before the first motion is detected in the first zones, issuing thealert with a user interface.
 17. The method of claim 10 furthercomprising receiving an indication of at least one location within thepatient room from an input of the user interface, wherein one or moreboundaries associated with heightened patient risk state are definedbased on the indication of the at least one location.
 18. The method ofclaim 10 further comprising issuing the alert to indicate the heightenedpatient risk state by generating one or both of a sound with a speakerof the user interface and a visible notification with a light or ascreen.
 19. A computing system for monitoring a patient in a patientarea, the computing system comprising memory and a processor, thecomputing system configured to: receive a plurality of video frames froma camera showing a patient area; monitor the plurality of video framesfor motion within each of a plurality of zones, the plurality of zonescomprising first zones that extend adjacently along a boundary outsideof a patient area, and second zones that extend adjacently along thefirst zones; in response to a first motion being detected in the firstzones before the first motion is detected in the second zones, issue analert indicative of a heightened patient risk state, wherein the firstmotion is associated with a first person or object; and in response to asecond motion being detected in the second zones before the secondmotion is detected in the first zones, disarm issuance of the alert,wherein the second motion is associated with a second person or object.